Diagnostic properties of the Italian ECAS Carer Interview (ECAS-CI)

Abstract

Background This study aimed at providing diagnostic properties and normative cut-offs for the Italian ECAS Carer Interview (ECAS-CI). Materials N = 292 non-demented ALS patients and N = 107 healthy controls (HCs) underwent the ECAS-CI and the Frontal Behavioural Inventory (FBI). Two ECAS-CI measures were addressed: (1) the number of symptoms (NoS; range = 0–13) and (2) that of individual symptom clusters (SC; range = 0–6). Diagnostics were explored against an FBI score ≥ than the 95th percentile of the patients’ distribution. Results Both the NoS and SC discriminated patient from HCs. High accuracy, sensitivity, and specificity were detected for both the NoS and SC; however, at variance with SC, the NoS showed better post-test features and did not overestimate the occurrence of behavioural changes. The ECAS-CI converged with the FBI and diverged from the cognitive section of the ECAS. Discussion The ECAS-CI is a suitable screener for behavioural changes in ALS patients, with the NoS being its best outcome measure (cut-off: ≥ 3).

Prevalence and determinants of language impairment in non‐demented amyotrophic lateral sclerosis patients

“…Response modality (i.e., written or oral) was adjusted based on the presence and severity of upper‐limb deficits and/or dysarthric features. Furthermore, patients underwent a behavioural assessment via the ECAS Carer Interview [ 15 , 16 ], Beck Depression Inventory [ 17 ] and State and Trait Anxiety Inventory Y (STAI‐Y1, trait anxiety; STAI‐Y2, state anxiety) [ 18 ], as well as a motor‐functional evaluation via the ALS Functional Rating Scale Revised (ALSFRS‐R) [ 19 ]. Disease staging was retrieved via both King's [ 20 ] and Milano–Torino systems [ 21 ], whereas progression rate (ΔFS) was computed as follows: (48 − ALSFRS‐R score)/disease duration in months [ 22 ].…”

Standardization of the Italian ALS-CBS™ Caregiver Behavioral Questionnaire

“…Patients' and HCs' first-degree relatives or spouses/partners were administered the Italian versions of the CBQ (Tremolizzo et al, 2020) and Edinburgh Cognitive and Behavioural ALS Screen-Carer Interview (ECAS-CI) (Poletti et al, 2016(Poletti et al, , 2022. The ECAS-CI was addressed as the main comparator against which the construct validity of the CBQ was tested (Sect.…”

“…In patients, the diagnostic properties of the CBQ-that is, sensitivity, specificity, positive and negative predictive values (PPV; NPV), and positive and negative likelihood ratios (LR +; LR-)were computed, through a receiver-operating characteristics (ROC) analysis, at the optimal cutoff identified via Youden's J statistic. An above-cutoff ECAS-CI score (Poletti et al, 2022) was addressed as the positive state (i.e., the presence of behavioral changes). In ROC analysis, the minimum sample size was set at N = 82, by forecasting a prevalence of up to 50% of patients with an above-cutoff ECAS-CI (i.e., allocation ratio of 1; 41 patients with an above-vs. below-cutoff ECAS-CI) (Strong et al, 2017), an AUC = 0.7, α = 0.05, and 1-β = 0.95 (Goksuluk et al, 2016).…”

“…Indeed, the CBQ proved to be heavily left-skewed and overdispersed; by reversing its scale, a rightskewed, overdispersed empirical distribution yielded, which could be thereupon modeled by the negative binomial; this allowed the transformed variable to keep the original metric and thus operationalization of the outcome measure (Aiello et al, 2020). Such an expedient already proved to be effective in circumventing ceiling/floor effects and high inter-individual variability in behavioral scores (Iazzolino et al, 2022;Poletti et al, 2022).…”